Lower Arm Flashcards
Borders cubital fossa
Medial- lateral pronator teres
Superior- epi condyle
Lateral- medial brachioradialis
Contents cubital fossa
radial nerve
biceps Tendon
brachial Artery
median Nerve
Muscles anterior forearm
Superficial (MEDIAN except for FCU)
- FCU, FCR, pronator teres, palmaris longus
Medial
- FDS (median)
Deep
- FPL, PDP, pronator quadratus
Lateral tendinopathy
- extensor
- tennis
- tears in extensor carpi radialis brevis
Olecranon bursitis
Inflammation of olecranon bursa
- repeated trauma
- transilluminates
proximal and distal articulations wrist joint
Proximal articulating surface –
Proximal row of carpal bones (minus pisiform)
• Distal articulating surface –
Distal end of radius + articular disk
flexion wrist
Flexor carpi ulnaris, flexor carpi radialis (+ FDS), palmaris longus
extension wrist
Extensor carpi radialis longus and brevis, extensor carpi ulnaris (+ extensor digitorum)
abduction wrist
Extensor carpi radialis longus and brevis, flexor carpi radialis, APL
adduction wrist
Flexor carpi ulnaris, extensor carpi ulnaris
extension at MCP, flexion at IP
lumbricals. lateral- median, medial- ulnar
abduction at MCPJ
dorsal interossei, ulnar
adduction at MCPJ
palmar interossei, ulnar
thenar muscles
opponens polliicis, abductor pollicis brevis, flexor pollicis brevis. MEDIAN
hypothenar
opponens digiti minimi, abdictor digiti minimi, flexor digiti minimi brevis. ULNAR
adductor
adductor pollicis, ULNAR
central
four lumbricals and palmaris brevis. median (lumbricals) ulnar (PB)
LOAF
median muscles. lateral two lumbricals. opponens pollicis. abductor pollicis brevis. flexor pollicis brevis.
boundaries anatomical snuffbox
Medial border: extensor pollicis longus TENDON
Lateral border:
extensor pollicis brevis + abductor pollicis longus TENDONS
Proximal border: radial styloid process
Floor: scaphoid and trapezium
• Roof:
skin
contents anatomical snuffbox
radial artery, superficial radial nerve, cephalic vein
scaphoid fracture
- FOOSH
- pain anatomical snuffbo
- avascular necrosis dorsal radial artery damaged
- splint or screw
complications scaphoid fracture
malunion, non union, avascular necrosis
roof and floor of carpal tunnel
Floor: carpal bones
• Roof: flexor retinaculum
carpal tunnel
Compression of the median nerve can result in symptoms of weakness, paraesthesia and pain, known as carpal tunnel syndrome
Usually worse during the night and relieved by shaking of the hand
treatment carpal tunnel
- Conservative management • Wrist splint worn at night particularly, preventing flexion of wrist • Corticosteroid injections if initial management unsuccessful
- Surgical management • Carpal tunnel release surgery – cutting through the flexor retinaculum to reduce the pressure • Incomplete release can result in persistent carpal tunnel syndrome symptoms
colles fracture
dorsal displacement of distal radius fracure, dinner fork deformity. FOOSH.
smiths fracture
displaced ventrally
dupuytrens contractures
thickened cord prevents straightening first.2 fingers
3 classes of nerve injuries
neurapraxia- temporary palsy
axonotmesis- axon and myelin sheath continuity lost, wallerian degeneration
neurotmesis- severence, wallerian regeneratiom
paracentral disc herniation vs far lateral vs central
paracentral- loss of traversing root
far lateral- loss of exiting root
central- compression of spinal cord
piriformis syndrome
compression of sciatic nerve by piriformis.
-dull ache in buttock, sciatica pain
meralgia paraesthesia
compression of lateral cutaenous femoral nerve as it passes through the inguinal ligament ror fascia lata. burning pain over lateral thigh. obesity, pregnancy.
erbs palsy
shoulder dystochia.
- c5/c6
- arm medially rotated, adducted and elbow extended
klumpkes palsy
forced hyperextension/abduction
- c8/t1
- claw hand, hyperextension of all MCPJ, abduction thumb
longest spinous process?
c7
jeffersons fracture
c1 fracture of anterior and posterior arches due to axial loading. no neuro injury
hangman frscture
c2. pars interarticularis. forced hyperextension.
odontoid process
hyperextension pr hyperflexion
order of brachial plexus
real teenagers drink cold beer
roots trunks (upper/middle/lower) divisions (anterior/posterior) cords (lateral posterior/medial) branches
roots musculocutaneous
3 musketeers
c5, c6, c7
roots axillary
assasinated
c5, c6
roots median
4 mice
c6, c7, c8, t1
roots radial
5 rats
c5, c6, c7, c8, t1
roots ulnar
2 unicorns
c8, t1
